Should parents who are at high risk of abusing their children, particularly those addicted to drugs, be allowed to retain custody of their children? Is this an issue that pertains to health, and if so should these ethical issues, as well as support of the family, be under the responsibility of healthcare professionals? According to the Tennessee Department of Health all healthcare professionals in the state of Tennessee are responsible, and legally bound to report the abuse of any child (O’Day, 2012). The purpose of this paper is to answer these questions with evidence based research, and give understanding to all aspects and sides of custody disputes between the department of human services and substance abusing parents for the benefit of the child.
Child abuse is the physical, emotional, and sexual mistreatment of children. To understand the role of a nurse regarding their involvement in Child Welfare Services it is important to have a strong definition of nursing and health. “The American Nurses Association defines nursing as the diagnosis and treatment of human responses to health and illness;” and the World Health Organization defines health as “the complete physical, mental and social well-being of an individual (Brunner & Suddarth 10th ed. p. 5-6).” One important way for nurses to diagnosis, provide treatment, and promote health is through preventative care. Preventative care can be broken down into three levels; primary, secondary, and tertiary.
Primary preventative care promotes the health and prevents illness of the individual by interventions that encourage healthy lifestyles. Primary prevention against drug abusing parents involves education against substance abuse, and unplanned pregnancy. Secondary prevention involves health risk appraisal. Any nurse who has reason to believe that a child is being abused is obligated to do a health risk appraisal of that child. Many abused children develop psychological and physical issues; the nurse is also involved in preventative measures that work to maximize their potential, regardless of these issues, and that is the goal of tertiary prevention.
Karen Winter through her researched on the perspectives of abused children aged four through seven, has provided insight into the benefits, and harm of out of home placement for these children. Her work analyzes four perspectives; “living with risk at home, removal from home, unresolved feelings after removal, and not being listened to (Winter, 2010, p.189).”
She makes many points on these perspectives that can be applied by those nurse’s involved with abused children. Regarding risks at home, the children she interviewed verbalized being exposed to violence, neglect, and witnessing substance abuse and violence. The fact that these children still recalled their situations, even though they were still in the young ages of four to seven, makes it apparent that child abuse has an effect early in their lives, and as such needs earlier intervention, especially if it is going to be preventative. Winter (2010) also points out that these children seemed to value the interview process, and were reluctant to leave (p.190). She attributes this to the interview process being therapeutic. This suggests that giving the child an opportunity to speak as individuals regarding their perspectives on being moved into foster care is beneficial.
The interviews of Aine and Finn, two abused children, both dealt with feelings of sadness, and guilt from being removed from their homes. Aine was subjected to severe neglect, and when she was taken out of the custody of her parents no one stopped to explain why. Furthermore, no one had explained previously to her that she was going to be moving out soon. This exposed her to shock, and further neglect.
This example shows the need for nurse’s to be involved with the social workers to...